DenialIntel

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B08M000838›TOMAS GARCIA

TOMAS GARCIA

Dependent on policy B08M000838

Claims
3
Attributed to this person
Charged
2,143.00
Total submitted
Denied
1,441.00
2 denied claims
Patient responsibility
0.00
Reported on the 835

Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.

Who this is

FieldValue
NameTOMAS GARCIA
Role on the policyDependent · relationship 19
PolicyB08M000838
Date of birth17 Jul 1984
PlanGOLD PPO
Covered from23 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00037506 Nov 2025702.00MERIDIAN HEALTH PLANNot denied—
CLM000374817 Jul 2025644.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY644.00
CLM000374925 Feb 2025797.00MERIDIAN HEALTH PLANCARC 11 · CODING797.00